scholarly journals The impact of orthotopic neobladder vs ileal conduit urinary diversion after cystectomy on the survival outcomes in patients with bladder cancer: A propensity score matched analysis

2020 ◽  
Vol 9 (20) ◽  
pp. 7590-7600
Author(s):  
Xiaohong Su ◽  
Kaihui Wu ◽  
Shuo Wang ◽  
Wei Su ◽  
Chuanyin Li ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Propensity Score ◽  
Urinary Diversion ◽  
Ileal Conduit ◽  
Survival Outcomes ◽  
Orthotopic Neobladder ◽  
The Impact

scholarly journals The Use of Regenerative Medicine in the Management of Invasive Bladder Cancer

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Matthew E. Hyndman ◽  
Deborah Kaye ◽  
Nicholas C. Field ◽  
Keith A. Lawson ◽  
Norm D. Smith ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Clinical Trials ◽  
Urinary Diversion ◽  
Ileal Conduit ◽  
Significant Morbidity ◽  
Orthotopic Neobladder ◽  
Great Opportunity ◽  
Novel Technologies ◽  
Muscle Invasive ◽  
Urinary Reconstruction

Muscle invasive and recurrent nonmuscle invasive bladder cancers have been traditionally treated with a radical cystectomy and urinary diversion. The urinary diversion is generally accomplished through the creation of an incontinent ileal conduit, continent catheterizable reservoir, or orthotopic neobladder utilizing small or large intestine. While radical extirpation of the bladder is often successful from an oncological perspective, there is a significant morbidity associated with enteric interposition within the genitourinary tract. Therefore, there is a great opportunity to decrease the morbidity of the surgical management of bladder cancer through utilization of novel technologies for creating a urinary diversion without the use of intestine. Clinical trials using neourinary conduits (NUC) seeded with autologous smooth muscle cells are currently in progress and may represent a significant surgical advance, potentially eliminating the complications associated with the use of gastrointestinal segments in the urinary reconstruction, simplifying the surgical procedure, and greatly facilitating recovery from cystectomy.

Prospective study of the impact on quality of life of cystectomy with ileal conduit urinary diversion for neurogenic bladder dysfunction

2011 ◽  
Vol 30 (8) ◽  
pp. 1503-1506 ◽  
Author(s):  
Julien Guillotreau ◽  
Evelyne Castel-Lacanal ◽  
Mathieu Roumiguié ◽  
Benoit Bordier ◽  
Nicolas Doumerc ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prospective Study ◽  
Urinary Diversion ◽  
Neurogenic Bladder ◽  
Bladder Dysfunction ◽  
Ileal Conduit ◽  
Neurogenic Bladder Dysfunction ◽  
The Impact

scholarly journals Comparison of a Significant Decline in the Glomerular Filtration Rate between Ileal Conduit and Ileal Neobladder Urinary Diversions after Radical Cystectomy: A Propensity Score-Matched Analysis

2020 ◽  
Vol 9 (7) ◽  
pp. 2236 ◽  
Author(s):  
Jihion Yu ◽  
Bumsik Hong ◽  
Jun-Young Park ◽  
Yongsoo Lee ◽  
Jai-Hyun Hwang ◽  
...  
Keyword(s):  
Propensity Score ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Filtration Rate ◽  
Ileal Conduit ◽  
Significant Decline ◽  
Ileal Neobladder ◽  
Renal Function Impairment ◽  
Function Impairment ◽  
Gfr Decline

Urinary diversion after radical cystectomy is associated with a risk of renal function impairment. A significant decline in the glomerular filtration rate (GFR) (i.e., a ≥30% decline in baseline GFR after 12 months) is associated with long-term renal function impairment. We compared the significant GFR decline between ileal conduit and ileal neobladder urinary diversions 12 months after radical cystectomy. We retrospectively included radical cystectomy patients. Propensity score-matched analysis was performed. The primary outcome was the incidence of a significant GFR decline in ileal conduit urinary diversion (ileal conduit group) and ileal neobladder urinary diversion (ileal neobladder group) 12 months after radical cystectomy. The secondary outcomes were the change of GFR and the incidence of end-stage renal disease (ESRD) in the two groups. After propensity score matching, the ileal conduit and neobladder groups had 117 patients each. The incidence of a significant GFR decline was not significantly different between ileal conduit and ileal neobladder groups (12.0% vs. 13.7%, p = 0.845). The change of GFR and ESRD incidence were not significantly different between the two groups (−8.4% vs. −9.7%, p = 0.480; 4.3% vs. 5.1%, p > 0.999, respectively). These results can provide important information on appropriate selection of the urinary diversion type in radical cystectomy.

Morbidity and Quality of Life in Elderly Patients Receiving Ileal Conduit or Orthotopic Neobladder After Radical Cystectomy for Invasive Bladder Cancer

Urology ◽  
2008 ◽  
Vol 71 (5) ◽  
pp. 919-923 ◽  
Author(s):  
Filippo Sogni ◽  
Maurizio Brausi ◽  
Bruno Frea ◽  
Carlo Martinengo ◽  
Fabrizio Faggiano ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bladder Cancer ◽  
Elderly Patients ◽  
Radical Cystectomy ◽  
Ileal Conduit ◽  
Invasive Bladder Cancer ◽  
Orthotopic Neobladder

Clinical and pathological outcomes for patients with T1HG bladder cancer managed with upfront cystectomy with or without neoadjuvant chemotherapy and the impact of the MDACC high-risk features.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 366-366
Author(s):  
Michael J. Metcalfe ◽  
James Edward Ferguson ◽  
Roger Li ◽  
Lianchun Xiao ◽  
Colin P.N. Dinney ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Neoadjuvant Chemotherapy ◽  
Systemic Disease ◽  
Survival Outcomes ◽  
Increased Risk ◽  
Node Positive Disease ◽  
Variant Histology ◽  
Muscle Invasive ◽  
The Impact

366 Background: In muscle invasive bladder cancer there is an increased risk for systemic disease identified for patients with certain high risk features (HRF): pre-operative hydronephrosis (POH), lymphovascular invasion (LVI), abnormal exam under anesthesia (AbnEUA), and the presence of variant histology (VH). We sought to identify the effect of these high risk features in the T1HG population. Methods: With IRB approval, a single center retrospective review was performed on all patients at MDACC from 1995-2013 who underwent radical cystectomy (RC) for T1HG urothelial cancer. Patients were stratified according to the presence or absence of HRF defined by the presence of LVI, POH, VH, AbnEUA, prostatic ductal involvement (PDI), and the delivery of neoadjuvant chemotherapy (NAC). Primary outcome included pathologic T (pT) upstage and presence of lymph node positive disease (LN+) at time of RC, as well as survival outcomes. Results: 372 T1HG patients underwent RC, of these 196 (53%) have HRF including: VH (n=98, 25%), LVI (n=44, 12%), PDI (n=31, 8%), POH (n=38, 10%) and/or AbnEUA (n=34, 9%). pT upstage occurred in 43/176 (24.4%) of patients without HRF, in 45/151 (30%) of patients with 1 HRF, and in 38% (17/45) of patients with > 2 HRF (p=0.088). LN+ occurred in 18/176 (10.2%) of patients without HRF, 7.8% (15/151) of patients with 1 HRF and in 17.8% (8/45) of patients with > 2 HRF (p=0.0403). Presence of HRF were not significant for a decreased OS (p=0.076), DSS (0.425), and RFS (p=0.103). No patients without HRF got NAC, and 41/196 (21%) of patients with HRF received NAC. There was no effect of NAC on pT upstage (OR 1.184, 95% CI 0.355-3.954, p=0.7834) or rate of LN+ disease (OR 1.758, 95% CI 0.669-5.606, p=0.2525) on multivariate analysis. There was no effect of NAC on OS (p=0.122), DSS (0.437), or RFS (0.7483). Conclusions: Presence of certain high risk features in the T1HG setting does have increased risk of pT upstage and LN+ disease in patients treated with cystectomy. However, there is no effect seen on survival outcomes. Use of NAC did not significantly alter outcome in our cohort and should be reserved for the muscle invasive setting.

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